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Intake & Approval Sheet (FOR PERMIT STAFF ONLY <br />PERMIT # CAS kk " 002"' <br />BUILDING <br />Intake OK by: Date: <br />Intake Comments: <br />❑ Route to Commercial Building <br />IQ Route to Residential Building <br />❑ Make this a "W" Permit <br />Bldg/TI/Addn/ e Size <br />C7 d .S , <br />Garage/Accessory Struct. Size <br />Number of Stories <br />°Z <br />Basement <br />JaqNo <br />❑Yes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />Occupancy Load <br />Fire Sprinklers: El Update Existing El New System ❑Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: ❑Update Existing El New System []Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes No <br />Add'I RCW 64.55 docs required prior to final? ❑Yes C3No <br />VALUATION CALCULATION: Total $ 49. -7g— <br />Additional Notes: Z.) /6- /QC <br />Approved By: Date: J Z <br />FIRE DEPARTMENT <br />Intake: (Needed for Townhomes, Alley load SFR, New Commercial) <br />❑ Route to Fire Drawer --- Fire Preliminary Review Notice <br />❑Sending Fire Notes to Project Team <br />Date: (OK to Route to Other Departments) <br />Fire Sprinklers: El Update Existing El New System ❑ Not Req'd <br />Fire Alarm: ❑Update Existing ❑New System ❑ Not Req'd <br />Chemical Sup: ❑Update Existing ❑New System ❑ Not Req'd <br />Additional Notes: <br />Approved By: Date: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: ( Date: - <br />Intake Comments: Assign To: <br />0"o-Z Q jj�— <br />❑ Attach to Project No. <br />❑ Route to Historic Reviewer <br />OK to Route to Other Departments <br />❑ Hold in Planning File Drawer <br />Zone <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />S <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes WNo <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />❑Everett S ool Dist ❑Mukilteo School Dist <br />Additional Notes: C".e o <br />Approved B Dater-, 2A •. tc)\ <br />PUBLIC WORKS <br />Intake OK by.--r i Date: 111 e51 2 e < <b <br />- -- ---------------------------- <br />Intake Comments: ;PIN Worksheet Needed if. <br />#4 CM NA -- <br />o ra�-� 5 e�wowe S ;[]Sys Dev Eval ❑Traffic Mit Eval <br />[]Site Work or Drainage Proposed <br />Ca o++► p� Ash ,,s�,r []Backflow Prevention for high hazard: <br />,(dental, medical, animals, mortuary, hospital, <br />;supportive housing) <br />----------------------------------------- <br />Route this folder for PW Review at end --- PW Review Worksheet <br />❑This project also has a separate concurrent PW Review (Green Folder) <br />AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br />❑ This Permit is Approved by Public Works <br />❑ See PW Review Worksheet and associated attached items <br />❑ A Separate PW Permit is Required (Permit #: PW ) <br />AND ❑ Is located in this folder <br />❑ Is in a Separate Green Folder (join with this folder for permit issuance) <br />❑ Will be Issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />UPublic Works has no scope --- PW Not Required <br />ditional No <br />Approved By: Date: <br />VIv <br />